| High density lipoprotein in patients with liver failure; relation to sepsis, adrenal function and outcome of illness. | |
| | |
MedLine Citation:
|
PMID: 22098564 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND AND AIMS: High density lipoprotein (HDL) plays an important role in the transport of cholesterol to the adrenal gland for steroidogenesis and may have actions that modulate response to infection and critical illness. The clinical relevance of HDL level in patients with liver failure remains poorly characterised. METHODS: In 164 critically-ill patients with acute (ALF) and acute on chronic liver failure (AOCLF) we evaluated the relationship between HDL levels measured on admission to intensive care unit (ICU) and survival, predisposition to sepsis and adrenocortical function assessed through the cortisol response to short synacthen testing (SST). RESULTS: In acute liver failure and acute on chronic liver failure, high density lipoprotein levels were significantly lower in non-survivors (P < 0.01). Levels correlated closely with biochemical markers of liver function and the duration of liver failure. However, predictive accuracy was not superior to conventional markers and on multi-variate analysis did not show independent association with survival. Low HDL concentration was not associated with an increased incidence of sepsis either precipitating or complicating ICU admission. Evidence of adrenocortical insufficiency was present in more than half of patients undergoing SST and HDL level but not other lipid parameters correlated closely with cortisol increment after SST (r = 0.364, P < 0.0001). CONCLUSIONS: High density lipoprotein levels are low in patients with liver failure and reflect its severity. Levels are lower in non-survivors but do not offer an advantage as early indicators of prognosis over conventional markers. No evidence of a major predisposing role for infection was found, but findings suggest a close link to adrenal function. |
| | |
Authors:
|
Frederique-Estelle Atogo-Asse; Royce P Vincent; Sarah A Hughes; Georg Auzinger; Carel W Le Roux; Julia Wendon; William Bernal |
Related Documents
:
|
3729584 - Pancreatic-duct reflux and acute gallstone pancreatitis. 9529984 - Comparative study of bentiromide test and endoscopic retrograde pancreatography in pati... 19421334 - Soluble e-cadherin: an early marker of severity in acute pancreatitis. 456844 - Postoperative elevation of amylase/creatinine clearance ratio in patients without pancr... 7788824 - Incidence of malignant hyperthermia reactions in 2,214 patients undergoing muscle biopsy. 22387034 - Deficiency of serum concentration of 25-hydroxyvitamin d in psoriatic patients: a case-... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-10-12 |
Journal Detail:
|
Title: Liver international : official journal of the International Association for the Study of the Liver Volume: - ISSN: 1478-3231 ISO Abbreviation: - Publication Date: 2011 Oct |
Date Detail:
|
Created Date: 2011-11-21 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101160857 Medline TA: Liver Int Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
|
© 2011 John Wiley & Sons A/S. |
Affiliation:
|
Liver Intensive Therapy Unit, Institute of Liver Studies, Kings College Hospital, London, UK. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Relationship between Monocyte/Macrophage Activation Marker Soluble CD163 and Insulin Resistance in O...
Next Document: The Role of Noninvasive Imaging in Early Diagnosis of Clinically Masked Prepulseless Inflammatory Ph...